(经经隧也)
夫心藏神。肺藏气肝藏血。脾藏肉。肾藏志。而各成形。志意通调。内连骨髓而成身形
五脏
。五脏之道。皆出于经隧。以行血气。血气不和。百病乃变化而生。是故守经隧焉。(五脏
在内经隧在外。脉道相通。故但守经。隧则可以治五脏之病。)神有余。则笑不休。神不足
。则悲。(阳胜则神王。故多喜而笑。阳衰则阴惨乘之。故多忧而悲。)血气未并。(正气未
与邪并。)五脏安定。邪客于形。洒淅起于毫毛未入于经络也。故命曰神之微。(此以浮浅微
邪在脉之表。神之微也。)神有余。则泻其小络之血勿之深斥。无中其大经。神气乃平。(小
络。孙络也。斥刺也)神不足者。视其虚络按而致之。刺而利之无出其血。无泄其气。以通
其经神气乃平。(以按摩致气于其虚络。又刺而利之。补不足以行其滞也)刺微者。按摩勿释
。着针勿斥。移气于不足。神气乃得复。(微邪在心经之表。当按摩勿释。欲散其外也。着
针勿斥。母伤其内也。)气有余。则喘咳上气。不足。则息利少气。血气未并。五脏安定。
皮肤微病。命曰白气微泄。(肺主皮肤。其色白。微邪客之。故命曰白气微泄。)气有余则写
其经隧无伤其经。无出其血。无泄其气。(有余尚尔。不足可知)不足则补其经隧。无出其气
。刺微者。按摩勿释。出针视之曰我将深之。适人必革。精气自伏。邪气散乱。无所休息。
气泄腠理。真气乃相得。(先行按摩之法。欲经隧之气不滞。次出针视之曰。我将深之欲其
恐惧而精神内伏也。然针之至人。必变革前说。而刺仍浅也。如是则精气潜伏。邪气散乱无
所止息而泄于外。真气得其所矣。)血有余则怒。不足则恐。血气未并。五脏安定。孙络外
溢。则经有留血。(此肝经之表邪也。但察其孙络之脉有外溢者。则大经之内有留止瘀血)血
有余。则泻其盛经。出其血(泻)不足则视其虚经。内针其脉中。久留而视脉大疾出其针。无
令血泄。(补虚之法。必留针候气视其脉渐大。是气已至则当连出针矣。)刺留血者。视其血
络。刺出其血。无令恶血得入于经。以成其疾。形有余。则腹胀泾溲不利。(脾湿胜。则气
壅不行。)不足。则四肢不用。(脾主四肢。虚则不用)血气未并。五脏安定。肌肉蠕(音软)
动命曰微风。(脾土畏风木风主动肌肉间如虫行动。故命曰微风。)形有余。则泻其阳经。(
刺足阳明经解 穴胃为脾之阳也)不足则补其阳络。(刺足阳明络丰隆穴。)刺微者取分肉间
。无中其经。无伤其络。卫气得复。邪气乃索。(散也。)志有余。则腹胀飧泄。(水化寒。
寒气在腹故尔。)不足则厥。(阴虚则阳胜。故厥逆上冲。)血气未并。五脏安定。骨节有动
。(邪未入藏。而薄于骨。故但于骨节之间有鼓动之状)志有余。则泻然谷血者。(血。出血
也)不足。则补其复溜。(皆足少阴经穴)刺未并者即取之。无中其经。邪所乃能立虚。(即其
邪
居之所取之。故无中其经穴。则邪自能去。)气血以并。(阴阳不和自为并一也。)阴阳相倾
。(倾倾陷也。)气乱于卫血逆于经血气离居一实一虚。(血气不相营合也。)血并于阴。(是
为重阴。)气并于阳。(是为重阳)故为惊狂。(病癫狂也。)血并于阳。(表寒)气并于阴。(里
寒)乃为炅(炯同)中。(热中也)血并于上。气并于下。心烦惋善怒。(血为阴并于鬲上。则阴
邪抑心。故烦惋气为阳。并于鬲下。则火动于肝。故善怒)血并于下。气并于上。乱而喜忘(
血并于下。则阴气不升。气并于上。则阳气不降。阴阳离散。故神乱而喜忘。)血气者。喜
温而恶寒。寒则泣不能流。温则消而去之。(此言血气并病之由也。)故气之所并为血虚。血
之所并为气虚。(言气并于阳血并于阴也。)有者为实。无者为虚。故气并则无血。血并则无
气。血与气相失。故为虚焉。络(□络)之与孙络。俱输于经。血与气并。则为实焉。血之与
气
。并走于上。则为大厥厥则暴死。(无阳则死。)气复反则生。不反则死。夫阴与阳。皆有俞
会。(经穴有俞有会。)阳注于阴阴满之外阴阳匀平。以充其形。九候若一。命曰平人夫邪之
生也。或生于阴。或生于阳其生于阳者。得之风雨寒暑。其生于阴者。得之饮食居处。阴
阳
喜怒。风雨之伤人也。先客于皮肤。传入于孙脉孙脉满。则传入于络脉络脉满。则输于大经
脉血气与邪并客于分腠之间。其脉坚大。故曰实实者外坚充满。不可按之。按之则痛。寒湿
之中人也。皮肤不收。(肌肤虚浮不收敛也。)肌肉坚紧。荣血涩。卫气去。故曰虚。虚者聂
辟。气不足。按之则气足以温之。故快然而不痛。(言语轻小曰聂。足弱不能行曰辟。)阴之
生实者。喜怒不节。则阴气上逆。上逆则下虚下虚则阳气走之。(凑之也。)故曰实矣。阴之
生虚者。喜则气下悲则气消。消则脉虚空。因寒饮食。寒气熏满。则血泣气去。故曰虚矣。
(此内伤之生虚也。若饮食过度留滞不消虽亦内伤。此为虚中挟实也。)阳虚则外寒。阴虚则
内热。阳盛则外热。阴盛则内寒。(义如下文。)阳受气于上焦。以温皮肤分肉之间。今寒气
在外。则上焦不通上焦不通。则寒气独留于外。故寒栗。(此明阳虚则外寒也。)有所劳倦。
形(阴)气衰少。谷气不盛。上焦不行。下脘不通胃气热热气熏胸中。故内热(此明阴虚生内
热也)上焦不通利则皮肤致密腠理闭塞。玄府不通。卫气不得泄越故外热(上焦之气。主阳分
也。故外伤寒邪。则上焦不通肌表闭塞卫气郁聚无所流行而为外热此明阳盛则外热外感症也
。)厥气上逆寒气积于胸中而不泻不泻则温气去寒独留(留)则血凝泣。凝(泣)则脉不通。其
脉盛大以涩故中寒(厥气寒厥之气也。寒留中焦阳气。乃去故经脉凝滞。此明阴盛生内寒
内
伤症也。)阴与阳并血气以并。病形以成刺之奈何刺此者取之经隧取血于营取气于卫用形哉
。因四时多少高下。(凡刺必用其形之长短肥瘦大小为法又当因天之四时寒暑温凉消息多少
者如以月生死为 数也高下者如春俞在颈项夏俞在胸胁秋俞在肩背冬俞在腰股也)血气以并
病。形以成阴阳相倾补泻奈何。泻实者气盛乃内针(因病患之吸气而入针)针与气俱内(气内
则神人不欲乱其真也)以开其门。如利其户。针与气俱出(候病患之呼气而出针)精气不伤邪
气乃下外门不闭以出其疾。摇大其道如利其路。是为大泻必切而出大气乃屈(行上文之法。
又必切中其疾。而后出针则大邪之气屈伏。真气亦无攒也)补虚奈何。持针勿置。以定其意
候呼内针气出针入。针空四塞。精无从去(针下气实则真气聚而不散也)方实。而疾出针。气
入针出(方其气至而针下实当即候吸出针也)热不得还闭塞其门邪气布散。精气乃得存。(热
针下之气热也)动气候时。近气不失。远气乃来是谓追之(追而济之是补法)五脏者。故得六
府
与为表里经络支节各生虚实其病所居随而调之。(脏腑相为表里。故为十二经经络各生支节
。故为三百六十五节。气脉贯通故皆合于五脏其间各生虚实则病有所在。调之之义如下文)
病在脉。调之血。(脉者血之府。)病在血。调之络(血和。则孙脉先满溢。乃注于络脉。故
血病者。当调络也。)病在气。调之卫(卫主阳气)病在肉调之分肉(随所在而取于分肉之间)
病在筋调之筋燔针劫刺其下。及与急者病在骨。调之骨淬针药熨(燔针者。内针之后以火燔
之暖淬针者用火先赤其针而后刺不但暖也若寒毒固结非此不可。今名火针。即此药熨者。以
辛热之药熨而散之。病有浅深故用分微甚耳。)病不知所痛两跷为上(湿痹为患当取足太阳之
申脉)身形有痛。九候莫病则缪刺之(病不在经而在络。当刺络脉也。)痛在于左而右脉病者
。巨刺之。(刺大经也。)必谨察其九候(诸经之九候。)针道备矣。
（经脉是运行气血的通道。）
心藏神。肺藏气，肝藏血，脾主肌肉，肾藏志。它们各自形成特定的形体功能。意志通畅调和，内连骨髓从而构成身形。
五脏。
五脏的联系通道，都出于经脉隧道，用来运行血气。如果血气不和，各种疾病就会由此产生变化而发生。因此，要守护好经脉隧道。（五脏在内，经脉隧道在外，脉道相通，所以只要守护好经脉隧道，就可以治疗五脏的疾病。）
神有余，就会笑个不停；神不足，就会悲伤。（阳气胜则神旺，所以多喜而笑；阳气衰则阴寒乘虚而入，所以多忧而悲。）
如果血气尚未偏聚（正气未与邪气相搏），五脏安定，邪气客于形体，使人洒淅恶寒，起于毫毛，但尚未进入经络。这叫做“神之微”（这是指浮浅微小的邪气在脉之表，属于神的轻微病变）。
神有余，就泻其小络中的血，不要深刺，不要伤及大经，神气就能平和。（小络即孙络，斥指针刺。）
神不足的，观察其虚损的络脉，按摩以引气至该处，然后针刺以疏通它，不要放出血液，不要泄耗其气，以疏通经脉，神气就能平和。（通过按摩将气引导至虚损的络脉，再针刺以疏通它，以补不足而行滞涩。）
刺治微邪者，按摩不要停止，下针时不要深刺，将气移至于不足之处，神气就能恢复。（微邪在心经之表，应当按摩不停止，以疏散外邪；下针不深刺，以免损伤内部。）
气有余，就会喘咳、气逆上冲；气不足，就会呼吸顺畅但气息微弱。
如果血气尚未偏聚，五脏安定，皮肤有轻微病变，叫做“白气微泄”。（肺主皮肤，其色白，微邪客之，所以叫做白气微泄。）
气有余，就泻其经隧，但不要伤及经脉本身，不要出血，不要泄气。（有余尚且如此，不足的情况可想而知。）
气不足，就补其经隧，不要泄气。
刺治微邪者，按摩不要停止，出针时看着病人说：“我要深刺。”借此使病人精神紧张，精气自然潜伏，邪气散乱，无处停留，从腠理泄出，真气就能恢复。（先进行按摩，欲使经隧之气不滞涩；其次出针时看着病人说：“我要深刺”，欲使其恐惧而精神内敛。然而高明的医生，必定改变这种说法，而实际仍浅刺。这样精气潜伏，邪气散乱无处休止而泄于外，真气得以安适。）
血有余，就会发怒；血不足，就会恐惧。
如果血气尚未偏聚，五脏安定，孙络外溢，则大经中有留瘀之血。（这是肝经之表的邪气，只观察孙络脉是否有外溢，如果有，则大经之内有留止的瘀血。）
血有余，就泻其盛满的经脉，放出血液。
血不足，就观察其虚损的经脉，将针刺入脉中，久留针并观察，待脉象变大时迅速出针，不要让血泄出。（补虚的方法，必须留针候气，观察脉象逐渐变大，说明气已到达，此时应当连续出针。）
刺治留血者，观察其血络，刺出其血，不要让恶血进入经脉，以免形成疾病。
形有余，就会腹胀、大小便不利。（脾湿胜，则气机壅滞不行。）
形不足，就会四肢不能运用。（脾主四肢，虚则不能运用。）
如果血气尚未偏聚，五脏安定，肌肉蠕动（音软），叫做“微风”。（脾土畏风木，风主动，肌肉间如虫行动，所以叫做微风。）
形有余，就泻其阳经。（刺足阳明经解溪穴，胃为脾之阳也。）
形不足，就补其阳络。（刺足阳明络丰隆穴。）
刺治微邪者，取分肉之间，不要伤及经脉，不要伤及络脉，卫气得以恢复，邪气乃消散。（索，散也。）
志有余，就会腹胀、完谷不化的泄泻。（水化寒，寒气在腹部所致。）
志不足，就会厥逆。（阴虚则阳胜，所以厥逆上冲。）
如果血气尚未偏聚，五脏安定，骨节有动。（邪气未入脏腑，而迫近于骨，所以在骨节之间有鼓动的状态。）
志有余，就泻然谷穴出血。（血，指出血。）
志不足，就补复溜穴。（都是足少阴经的穴位。）
刺治未偏聚者，即在其邪气所在之处取穴，不要伤及经脉，邪气所在之处能使邪气立消。（即在邪气居留之所取穴，所以不伤及经穴，邪气自然能去除。）
气血相并。（阴阳不和，自相并合。）
阴阳相倾。（倾，倾陷也。）
气乱于卫分，血逆于经，血气离居，一实一虚。（血气不相营合。）
血并于阴。（这是重阴。）
气并于阳。（这是重阳）
所以出现惊狂。（病癫狂。）
血并于阳。（表寒）
气并于阴。（里寒）
于是出现炅中（炯同，热中也）。（热中症。）
血并于上，气并于下，心烦闷善怒。（血为阴，并于膈上，则阴邪抑制心，所以烦闷；气为阳，并于膈下，则火动于肝，所以善怒。）
血并于下，气并于上，神乱而喜忘。（血并于下，则阴气不升；气并于上，则阳气不降。阴阳离散，所以神乱而喜忘。）
血气者，喜欢温暖而厌恶寒冷。寒冷则凝泣不能流动，温暖则消散而去之。（这是说明血气并病的成因。）
所以气之所并，则血虚；血之所并，则气虚。（指气并于阳，血并于阴。）
有者为实，无者为虚。所以气并则无血，血并则无气。血与气相失，所以为虚。
络脉与孙络，都输注于经脉。血与气并，则为实。
血与气，并走于上，则为大厥，厥则暴死。（无阳则死。）
气复反则生，不反则死。
夫阴与阳，都有腧会。（经穴有俞穴，有会穴。）
阳注入阴，阴满之外，阴阳匀平，以充养其形体，九候脉象一致，叫做平人。
夫邪气的产生，有的生于阴，有的生于阳。生于阳的，得之于风雨寒暑；生于阴的，得之于饮食居处、阴阳喜怒。
风雨之伤人，先客于皮肤，传入于孙脉；孙脉满，则传入于络脉；络脉满，则输注于大经脉。血气与邪气相并，客于分腠之间，其脉坚大，所以叫做实。实证者，外表坚实充满，不可按压，按压则痛。
寒湿之中人也，皮肤不收（肌肤虚浮不收敛）。肌肉坚紧，荣血涩滞，卫气离去，所以叫做虚。虚者聂辟（言语轻小曰聂，足弱不能行曰辟），气不足，按压则气足以温之，所以快然而不痛。
阴之生实者，喜怒不节，则阴气上逆，上逆则下虚，下虚则阳气走之（凑之也）。所以叫做实了。
阴之生虚者，喜则气下，悲则气消，消则脉虚空，因寒饮食，寒气熏满，则血泣气去，所以叫做虚了。（这是内伤生虚的情况。若饮食过度留滞不消，虽也是内伤，此为虚中挟实。）
阳虚则外寒，阴虚则内热，阳盛则外热，阴盛则内寒。（义如下文。）
阳受气于上焦，以温皮肤分肉之间。现在寒气在外，则上焦不通，上焦不通，则寒气独留于外，所以寒栗。（这是阐明阳虚则外寒。）
有所劳倦，形（阴）气衰少，谷气不盛，上焦不行，下脘不通，胃气热，热气熏胸中，所以内热。（这是阐明阴虚生内热。）
上焦不通利，则皮肤致密，腠理闭塞，玄府不通，卫气不得泄越，所以外热。（上焦之气，主阳分也。所以外伤寒邪，则上焦不通，肌表闭塞，卫气郁聚无所流行而为外热。这是阐明阳盛则外热的外感症。）
厥气上逆，寒气积于胸中而不泻，不泻则温气去，寒独留（留），则血凝泣，凝（泣）则脉不通。其脉盛大以涩，所以中寒（厥气，寒厥之气也。寒留中焦，阳气乃去，故经脉凝滞。这是阐明阴盛生内寒的内伤症。）
阴与阳并，血气以并，病形以成，刺之奈何？
刺此者，取之经隧，取血于营，取气于卫，用形哉，因四时多少高下。（凡刺必用其形体之长短肥瘦大小为法，又当因天之四时寒暑温凉消息多少者，如以月生死为数也。高下者，如春俞在颈项，夏俞在胸胁，秋俞在肩背，冬俞在腰股也。）
血气以并病，形以成，阴阳相倾，补泻奈何？
泻实者，气盛乃内针（因病患之吸气而入针），针与气俱内（气内则神人不欲乱其真也），以开其门，如利其户。针与气俱出（候病患之呼气而出针），精气不伤，邪气乃下，外门不闭，以出其疾。摇大其道，如利其路，是为大泻。必切而出，大气乃屈（行上文之法，又必切中其疾，而后出针，则大邪之气屈伏，真气亦无攒也）。
补虚奈何？持针勿置，以定其意。候呼内针，气出针入，针空四塞，精无从去（针下气实则真气聚而不散也）。方实，而疾出针，气入针出（方其气至而针下实，当即候吸出针也），热不得还，闭塞其门，邪气布散，精气乃得存。（热，针下之气热也。）动气候时，近气不失，远气乃来，是谓追之（追而济之是补法）。
五脏者，故得六腑与为表里，经络支节各生虚实，其病所居，随而调之。（脏腑相为表里，故为十二经。经络各生支节，故为三百六十五节。气脉贯通，故皆合于五脏。其间各生虚实，则病有所在。调之之义如下文。）
病在脉，调之血。（脉者，血之府。）
病在血，调之络（血和，则孙脉先满溢，乃注于络脉，故血病者，当调络也。）
病在气，调之卫（卫主阳气）。
病在肉，调之分肉（随所在而取于分肉之间）。
病在筋，调之筋燔针劫刺其下，及与急者。
病在骨，调之骨淬针药熨（燔针者，内针之后以火燔之暖；淬针者，用火先赤其针而后刺，不但暖也。若寒毒固结，非此不可。今名火针，即此。药熨者，以辛热之药熨而散之。病有浅深，故用分微甚耳。）
病不知所痛，两跷为上（湿痹为患，当取足太阳之申脉）。
身形有痛，九候莫病，则缪刺之（病不在经而在络，当刺络脉也）。
痛在于左而右脉病者，巨刺之。（刺大经也。）
必谨察其九候（诸经之九候）。针道备矣。
(The meridians are the tunnels through which Qi and Blood flow.)
The Heart stores Shen (Spirit). The Lungs store Qi, the Liver stores Blood, the Spleen governs muscles, and the Kidneys store Zhi (Will). Each forms a specific physical manifestation. When Yi (Intent) and Zhi are smooth and harmonious, they connect internally with the Marrow to form the body structure.
Five Zang Organs.
The pathways of the Five Zang Organs all emerge from the meridian tunnels to circulate Qi and Blood. If Qi and Blood are disharmonious, various diseases arise and change. Therefore, one must guard the meridian tunnels. (The Zang organs are internal, while the meridian tunnels are external; the vessel channels are connected. Thus, by guarding the meridians and tunnels, diseases of the five Zang organs can be treated.)
Excess of Shen manifests as unceasing laughter; deficiency of Shen manifests as sadness. (When Yang is excessive, Shen is vigorous, leading to joy and laughter; when Yang is deficient, Yin cold takes advantage, leading to worry and sadness.)
If Qi and Blood have not yet aggregated (Zheng Qi has not yet contended with pathogenic factors), and the Five Zang organs are stable, but pathogens invade the形体 (body surface), causing chills starting from the hair follicles without entering the meridians, this is called "Wei Xiao Shen" (Subtle Disorder of Shen). (This refers to superficial, subtle pathogens on the exterior of the vessels, representing a slight disorder of Shen.)
In cases of Shen excess, drain the blood from the small collaterals (Xiao Luo), do not pierce deeply, and avoid damaging the main meridians, so that Shen Qi will return to balance. (Small collaterals refer to Sun Luo [branch collaterals]; Chi refers to needle insertion.)
In cases of Shen deficiency, observe the deficient collaterals, massage to guide Qi to them, then puncture to promote flow. Do not bleed, and do not dissipate Qi. By unblocking the meridians, Shen Qi will return to balance. (By massaging to guide Qi to the deficient collaterals, and then puncturing to promote flow, one tonifies deficiency and moves stagnation.)
For treating subtle pathogens, massage without releasing, insert the needle without deep thrusting, and shift Qi to the deficient areas so that Shen Qi recovers. (Subtle pathogens are on the exterior of the Heart Meridian; massage should continue to disperse external pathogens; inserting the needle without deep thrusting prevents damage to the interior.)
Excess of Qi manifests as wheezing, coughing, and rebellious Qi rising; deficiency of Qi manifests as free breathing but shortness of breath.
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, with only slight skin pathology, it is called "Bai Qi Wei Xie" (Slight Leakage of White Qi). (The Lungs govern the skin and their color is white; slight pathogens invading cause this name.)
In cases of Qi excess, drain the meridian tunnels without damaging the meridians themselves, without bleeding, and without dissipating Qi. (If this applies to excess, deficiency is understood similarly.)
In cases of Qi deficiency, tonify the meridian tunnels without dissipating Qi.
For treating subtle pathogens, massage without releasing. When withdrawing the needle, look at the patient and say, "I will insert it deeply." This induces a state of alertness where Jing Qi settles inward, pathogenic Qi scatters, finds no rest, and leaks out through the Cou Li (pores/skin spaces), allowing True Qi to recover. (First, massage to prevent stagnation in the meridian tunnels; second, verbally suggesting deep insertion induces mental focus and inward settling of Jing Qi. However, skilled practitioners may alter this verbal cue while actually using shallow needling. Thus, Jing Qi remains settled, pathogenic Qi scatters externally, and True Qi is restored.)
Excess of Blood manifests as anger; deficiency of Blood manifests as fear.
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, with overflow from the Sun Luo, there is stagnant blood in the main meridians. (This is pathogenic influence on the exterior of the Liver Meridian. Observing overflow in the Sun Luo indicates stagnant blood within the main meridians.)
In cases of Blood excess, drain the full meridians and release blood.
In cases of Blood deficiency, observe the deficient meridians, insert the needle into the vessel, retain it for a long time while observing, and withdraw quickly once the pulse becomes large. Do not allow blood to leak. (The method for tonifying deficiency involves retaining the needle to await Qi arrival; observing the pulse gradually enlarge indicates Qi has arrived, warranting quick withdrawal.)
To treat stagnant blood, observe the blood collaterals, puncture to release blood, ensuring evil blood does not enter the meridians to form disease.
Excess of Form (Xing) manifests as abdominal distension and difficulty in urination and defecation. (Spleen dampness prevails, causing Qi stagnation.)
Deficiency of Form manifests as inability to use the four limbs. (The Spleen governs the four limbs; deficiency leads to dysfunction.)
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, with twitching muscles, it is called "Wei Feng" (Gentle Wind). (Earth fears Wood/Wind; Wind causes movement. Twitching in the muscles like insects moving is thus called Gentle Wind.)
In cases of Form excess, drain the Yang meridians. (Puncture Jie Xi of the Foot-Yangming Stomach Meridian, as the Stomach is the Yang aspect of the Spleen.)
In cases of Form deficiency, tonify the Yang collaterals. (Puncture Feng Long of the Foot-Yangming Collateral.)
For treating subtle pathogens, select points between the muscle layers, avoiding the meridians and collaterals. Once Wei Qi recovers, the pathogenic Qi disperses. (Suo means to scatter.)
Excess of Zhi (Will) manifests as abdominal distension and undigested food diarrhea. (Water transforms into cold; cold qi resides in the abdomen.)
Deficiency of Zhi manifests as Jue (reversal/cold extremities). (Yin deficiency leads to Yang excess, causing reversal Qi to rush upward.)
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, there is movement in the bone joints. (Pathogens have not entered the Zang organs but press against the bones, causing pulsation in the joints.)
In cases of Zhi excess, bleed Ran Gu. (Blood here refers to inducing bleeding.)
In cases of Zhi deficiency, tonify Fu Liu. (Both are points on the Foot-Shaoyin Kidney Meridian.)
For treating non-aggregated states, select points where the pathogen resides, avoiding the main meridians, so the pathogenic Qi can be instantly vacated. (Selecting points at the pathogen's location avoids damaging the meridians, allowing the pathogen to depart naturally.)
Qi and Blood aggregating together. (Yin and Yang are disharmonious, merging with each other.)
Yin and Yang leaning/falling. (Qing means sinking or collapsing.)
Qi chaotic in the Wei (Defensive) level, Blood rebellious in the Jing (Main) vessels, Qi and Blood separated in residence, one excess and one deficient. (Qi and Blood fail to nourish each other.)
Blood aggregating in Yin. (This is Heavy Yin.)
Qi aggregating in Yang. (This is Heavy Yang)
Thus,惊狂 (Fright and Mania) occur. (Diseases of mania.)
Blood aggregating in Yang. (Exterior Cold)
Qi aggregating in Yin. (Interior Cold)
Thus, Jiong Zhong (Heat Stroke/Interior Heat) occurs. (Heat in the middle.)
Blood aggregating above, Qi aggregating below: Heart vexation, depression, and irritability. (Blood, being Yin, aggregates above the Diaphragm, suppressing the Heart with Yin pathogen, causing vexation; Qi, being Yang, aggregates below the Diaphragm, stirring Fire in the Liver, causing irritability.)
Blood aggregating below, Qi aggregating above: Confusion and forgetfulness. (Blood below prevents Yin Qi from ascending; Qi above prevents Yang Qi from descending. Yin and Yang separate, causing Shen chaos and forgetfulness.)
Qi and Blood prefer warmth and dislike cold. Cold causes stagnation and immobility; warmth causes dissipation and removal. (This explains the origin of Qi and Blood aggregation diseases.)
Therefore, where Qi aggregates, Blood is deficient; where Blood aggregates, Qi is deficient. (Referring to Qi aggregating in Yang and Blood aggregating in Yin.)
Presence constitutes Excess (Shi); absence constitutes Deficiency (Xu). Thus, Qi aggregation implies lack of Blood; Blood aggregation implies lack of Qi. Loss of connection between Blood and Qi results in Deficiency.
Luo (Collateral) and Sun Luo (Branch Collaterals) both transport to the Jing (Main) meridians. When Blood and Qi aggregate, it constitutes Excess.
If Blood and Qi both rush upward, it results in Da Jue (Great Reversal), leading to sudden death. (Death occurs without Yang.)
If Qi returns, life is preserved; if it does not return, death ensues.
Yin and Yang both have Shu (Transporting) and Hui (Meeting) points. (Acupoints include Shu and Hui points.)
Yang pours into Yin; when Yin is full, it extends outward. When Yin and Yang are balanced and even, they fill the形体 (body). If the Nine Pulses are uniform, the person is called Ping Ren (Healthy Person).
Pathogens arise either from Yin or from Yang. Those arising from Yang result from Wind, Rain, Cold, and Summer-heat. Those arising from Yin result from Diet, Lifestyle, and Emotional fluctuations (Joy, Anger, etc.).
Wind and Rain injure humans first by lodging in the Skin, transmitting to Sun Luo; when Sun Luo is full, it transmits to Luo Mai; when Luo Mai is full, it transports to the Da Jing (Main Meridians). Qi and Blood combine with pathogens and lodge between the Fen Sou (muscle intervals). The pulse becomes firm and large, hence termed Shi (Excess). In Excess conditions, the exterior is firm and full, cannot be pressed, and pressing causes pain.
Cold-Dampness injuring humans causes the skin to relax and not contract (muscles and skin are flaccid and loose). Muscles become tight and hard, Ying Blood becomes sluggish, and Wei Qi departs, hence termed Xu (Deficiency). In Xu conditions, speech is quiet and gait is weak (Nie refers to quiet speech; Pi refers to weak legs unable to walk). Qi is insufficient; pressing generates Qi to warm, bringing relief and absence of pain.
Yin generating Excess: Unregulated emotions cause Yin Qi to rebel upward. Upward rebellion causes lower deficiency; lower deficiency allows Yang Qi to rush in. Hence, it is termed Excess.
Yin generating Deficiency: Joy causes Qi to sink; Sadness causes Qi to dissipate. Dissipation leaves vessels empty. Combined with cold diet, cold Qi fills the area, causing Blood to stagnate and Qi to depart. Hence, it is termed Deficiency. (This describes internal injury causing Deficiency. Overeating causing stagnation is also internal injury, but represents Deficiency mixed with Excess.)
Yang Deficiency leads to Exterior Cold; Yin Deficiency leads to Interior Heat. Yang Excess leads to Exterior Heat; Yin Excess leads to Interior Cold. (Meaning follows below.)
Yang receives Qi from the Upper Jiao to warm the skin and muscle intervals. Now, if Cold is external, the Upper Jiao becomes blocked. Blockage of the Upper Jiao causes Cold to remain solely on the exterior, resulting in chills. (This clarifies Yang Deficiency leading to Exterior Cold.)
Labor and fatigue cause Yin Qi to decline and Grain Qi to be insufficient. The Upper Jiao fails to function, and the Lower Wan (stomach outlet) is blocked. Stomach Qi becomes hot, and hot Qi steams the chest, resulting in Interior Heat. (This clarifies Yin Deficiency generating Interior Heat.)
Blockage of the Upper Jiao leads to dense skin, closed Cou Li, and blocked Xuan Fu (pores). Wei Qi cannot vent, resulting in Exterior Heat. (The Qi of the Upper Jiao governs the Yang aspect. External Cold blocks the Upper Jiao, closing the muscle surface, causing Wei Qi to stagnate and generate Exterior Heat. This clarifies Yang Excess leading to Exterior Heat in external contraction syndromes.)
Rebellious Qi rises, Cold accumulates in the chest and does not dissipate. Lack of dissipation causes Warm Qi to depart, leaving Cold alone. Blood coagulates and stagnates, vessels become blocked. The pulse is large and choppy, indicating Middle Cold. (Jue Qi refers to Cold Reversal Qi. Cold remaining in the Middle Jiao causes Yang Qi to depart and meridians to stagnate. This clarifies Yin Excess generating Interior Cold in internal injury syndromes.)
When Yin and Yang merge, and Qi and Blood aggregate, forming disease patterns, how should one puncture?
To treat this, select the meridian tunnels, draw Blood from Ying (Nutrient) and Qi from Wei (Defensive). Utilize the patient's physique and adjust according to the Four Seasons, considering quantity and depth. (Needling must adapt to the patient's height, fat/thinness, and size. It must also follow the seasonal changes—cold, heat, warmth, coolness—and lunar phases. Depth varies by season: Spring points in neck/neck, Summer in chest/hypochondrium, Autumn in shoulders/back, Winter in waist/thighs.)
When Qi and Blood aggregate, forming disease, and Yin/Yang lean, how to tonify and sedate?
To sedate Excess: Insert the needle when Qi is abundant (during patient's inhalation). The needle enters with the Qi (preserving Shen and preventing disturbance of True Qi). Open the gate, like opening a door. Withdraw the needle with the Qi (during patient's exhalation). Jing Qi is not damaged, Pathogenic Qi descends. The outer gate remains open to expel the disease. Widen the channel, like clearing a road. This is major sedation. Press upon withdrawal to ensure the major pathogenic Qi is subdued, preserving True Qi.
How to tonify Deficiency? Hold the needle steady, focus intention. Insert during exhalation (Qi exits, needle enters). Seal the needle space tightly so Jing Qi cannot escape (when Qi arrives under the needle, True Qi gathers and does not scatter). When the sensation is full, withdraw quickly. As Qi enters, the needle exits. Heat (from the needle/Qi interaction) cannot return; seal the pore. Pathogenic Qi scatters, Jing Qi is preserved. (Heat refers to the warmth under the needle.) Move the needle to await the right timing. Do not lose nearby Qi, invite distant Qi. This is called "Chasing" (Pursuing and assisting, a tonification method).
The Five Zang organs have the Six Fu organs as their interior-exterior pairs. Meridians and branches/joints each generate Excess and Deficiency. Based on the disease location, regulate accordingly. (Zang and Fu are paired, forming twelve meridians. Meridians branch into 365 joints. Qi and pulses connect, integrating with the Five Zang. Variations in Excess/Deficiency determine disease location. Regulation methods follow below.)
Disease in the Pulse: Regulate Blood. (Vessels are the mansion of Blood.)
Disease in Blood: Regulate Collaterals. (When Blood is harmonious, Sun Luo fill first, then pour into Luo Mai. Thus, Blood diseases require regulating collaterals.)
Disease in Qi: Regulate Wei. (Wei governs Yang Qi.)
Disease in Flesh: Regulate Muscle Intervals. (Select points between muscle layers based on location.)
Disease in Tendons: Regulate Tendons using Burning Needles (Fan Zhen) and rapid stabbing below, and for spasms.
Disease in Bone: Regulate Bones using Quenching Needles (Cui Zhen) and Herbal Hot Compresses. (Burning needles involve heating the needle after insertion for warmth; Quenching needles involve heating the needle red-hot before insertion for stronger warming. Necessary for stubborn Cold-Toxins. Now called Fire Needle. Herbal compresses use pungent-hot herbs to disperse. Usage depends on disease depth and severity.)
Disease with unknown pain location: Use the Two Chong Mai (Penetrating Vessels) as primary points (for Damp-Bi, select Shen Mai of Foot-Taiyang).
Body pain with normal Nine Pulses: Use Miao Ci (Mysterious Puncture). (Disease is in collaterals, not meridians; puncture collaterals.)
Pain on the left with abnormal pulse on the right: Use Ju Ci (Major Puncture). (Puncture major meridians.)
Must carefully examine the Nine Pulses (Nine pulses of all meridians). The Way of Needling is complete.